| NPI | 1902827926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN ENGER Office Manager 972-680-9882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 13073) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2012-01-18 |